Christopher N Kaufmann1, Mark W Bondi2,3, Wesley K Thompson4, Adam P Spira5,6,7, Sonia Ancoli-Israel8, Atul Malhotra9. 1. Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida College of Medicine, Florida, Gainesville, USA. 2. Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, California, USA. 3. VA San Diego Healthcare System, La Jolla, California, USA. 4. Population Neuroscience and Genetics Lab, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA. 5. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 6. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 7. Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA. 8. Department of Psychiatry and Center for Circadian Biology, University of California San Diego School of Medicine, La Jolla, California, USA. 9. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California San Diego School of Medicine, La Jolla, CaliforniaUSA.
Abstract
BACKGROUND: Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHOD: Data came from the 2006-2014 Health and Retirement Study (HRS). At each of 5 waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior 2 weeks, they had taken medications or used other treatments to improve sleep. Our sample (N = 3 957) included individuals who at HRS 2006 were 50 years and older, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving versus not receiving treatment in subsequent waves and, among those treated (n = 1 247), compared cognitive trajectories before and after treatment. RESULTS: At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher body mass index, and more depressive symptoms (all ps ≤ .015). Decline in cognitive performance was mitigated in periods after sleep treatment versus periods before (B = -0.20, 95% CI = [-0.25, -0.15], p < .001 vs B = -0.26, 95% CI = [-0.32, -0.20], p < .001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance-those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS: In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.
BACKGROUND: Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHOD: Data came from the 2006-2014 Health and Retirement Study (HRS). At each of 5 waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior 2 weeks, they had taken medications or used other treatments to improve sleep. Our sample (N = 3 957) included individuals who at HRS 2006 were 50 years and older, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving versus not receiving treatment in subsequent waves and, among those treated (n = 1 247), compared cognitive trajectories before and after treatment. RESULTS: At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher body mass index, and more depressive symptoms (all ps ≤ .015). Decline in cognitive performance was mitigated in periods after sleep treatment versus periods before (B = -0.20, 95% CI = [-0.25, -0.15], p < .001 vs B = -0.26, 95% CI = [-0.32, -0.20], p < .001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance-those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS: In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.
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